1. Roadmap to an Organizational Culture of QI
Pooja Verma, NACCHO, APQI
Ty Kane, SCHD

2. Roadmap to an Organizational Culture of QI
EXIT 6
EXITS 4-5
6. QI CULTURE
4. SOME FORMAL QI ACTIVITIES
5. FORMAL AGENCY-WIDE QI
3. INFORMAL OR AD HOC QI ACTIVITIES
EXIT 3
EXITS 1-2
1. NO KNOWLEDGE OF QI
2. NOT INVOLVED IN QI ACTIVITIES

3. Roadmap to an Organizational Culture of QI
Characteristics
Lack awareness/understanding of QI
Overwhelmed with other issues
Satisfaction with status quo
Don’t value/link QI to PH practice
Strategies for Transition
Marketing QI to leaders
Leadership & staff training
Share stories of success
Incentives for engaging in QI
Intentionally manage change
“Deselect” resistant leaders
EXIT 1
NO KNOWLEDGE OF QI
EXIT 1

4. Roadmap to an Organizational Culture of QI
Characteristics
Begin to embrace/understand QI
Problems are ignored/buried
Staff are viewed “hired hands”
Data are not available or not used
Strategies for Transition
Mentorship
Integrate QI in agency planning
‘Firefighters’ to problem solvers
Task-focus to QI project focus
Membership in ASQ
Market QI thru successes
EXIT 2
Not Involved With QI Activities

5. Roadmap to an Organizational Culture of QI
Characteristics
Data not routinely used
Discrete QI efforts
“Pseudo-QI”
QI not part of organization’s strategy
Few lessons learned and sharing
Anxiety of
Doing it wrong or
Finding problems
Strategies for Transition
Share stories organization-wide
Build learning communities
Performance management
Demystify QI
Celebrate all improvements
Address resistance to change
EXIT 3
INFORMAL OR AD HOC QI ACTIVITIES

6. Roadmap to an Organizational Culture of QI
Characteristics
Greater reliance on data
Fewer ‘firefighter’ supervisors
People viewed as critical to success
QI is a part of the job
In-house QI TA available
Strategies for Transition
QI division or function
Sharing QI results externally
Results-sharing is the norm
More working across silos
Data use/access increases
Talk of systematic Performance Management
Draft a comprehensive QI plan
Join ASQ
Report results to local governance
EXIT 4
FORMAL QI ACTIVITIES IMPLEMENTED IN SPECIFIC AREAS ONLY

7. Roadmap to an Organizational Culture of QI
Characteristics
More data-driven decisions
QI plan individualized to setting
Integration of measures into “system”
QI integrated in operational plans
QI becomes more visible
Standardization in processes
Learning/sharing culture
QI in position descriptions
Customer-focus
Demonstrate ROI
QI policies
Strategies for Transition
QI on all meeting agendas
Leadership that walks the talk
Supervisors are QI coaches
EXIT 5
FORMAL AGENCY-WIDE QI

8. Roadmap to an Organizational Culture of QI
Characteristics
Distribution of results to staff, stakeholders and customers
QI champions throughout organization
Ongoing training and networking
Data and tools used daily
Customer is front and center
Integrate with strategic plan
Getting better all the time
Self-assessment
Problems are “gold”
Sustainability
Caution: Digression is easier than progression
EXIT 6
QI CULTURE

9. Foundational Characteristics: The following characteristics were identified throughout every phase in the roadmap:
Selecting employees who are well-suited to learn and teach QI techniques
A Collaborative AND learning culture
QI should be integrated into strategic plan
Data analysis skills AND problem solving skills (tools)
Leadership (including governance) must be engaged and have knowledge
Theoretical vs. practical balance (50,000 ft and 5 ft view)
Flexibility in decision-making (at all levels) is seen as critical piece to success
Supervisors are expected to engage in QI and see their job not as about fighting fires but rather, improving processes
Customer focus
QI should be integrated into funder requirements (expected as program work, not “extra”)